Jean-Martin Charcot: the polymath

Jean-Martin Charcot, widely regarded as a leading founder of modern neurology, made substantial contributions to the understanding and characterization of numerous medical conditions. His initial focus was on internal medicine, later expanding to include neuropathology, general neurology, and eventually emerging fields such as neuropsychology and neuropsychiatry. Furthermore, Charcot's intellectual pursuits extended beyond medicine, encompassing research in art history, medical iconography, sociology, religious studies, and the arts, solidifying his status as a polymath.


INTRODUCTION
In 2020, Peter Burke, Professor Emeritus of Cultural History at the University of Cambridge, published the book entitled "The Polymath.A cultural history from Leonardo da Vinci to Susan Sontag." 1 In the introduction to this famous book, the author defined a polymath as "someone who is interested in many subjects and learns many subjects."Five hundred Western polymaths were presented, including preeminent and controversial physicians such as Erasmus Darwin (1731-1802), Paul Broca (1824-1880), Sigmund Freud (1856-1939)  and Oliver Sacks (1933-2015), but interesting omits Jean-Martin Charcot (1825-1893). 1 Apart from being widely considered a leading founder of modern neurology, Charcot's revolutionary ideas about neurological diseases continue to shape the practices of clinicians and scientists to this very day.3][4][5] This breadth of knowledge and involvement undoubtedly qualifies him as a polymath. 1he purpose of this article is to briefly present Charcot's main contributions to neurology and beyond.

CHARCOT: A SHORT BIOGRAPHY
Jean-Martin Charcot (►Figure 1) was born on November 29, 1825, at 1 rue du Faubourg Poissonnière, 9th arrondissement, Paris, France.His parents were Simon-Pierre Charcot (1798-1863) and Jeanne-Georgette Saussier (1808-1839).][8] During his youth, Charcot was described as a slender individual with long black hair combed back, and he tended to keep to himself, rarely interacting with his peers. 8At the age of 38, in 1864, Charcot married Augustine-Victoire Laurent (1834-1899), a widow with a 10-year-old daughter named Maria Charlotte Thérèse Durvis (1854-1936).Together, Charcot and Augustine-Victoire had two children: Jeanne Marie Amélie Claudine Charcot (1865-1940) and Jean-Baptiste Charcot (1867-1937). 2,6,7harcot pursued his education and graduated in letters before enrolling in the École de Médecine in Paris in 1843.After successfully passing the external competition in December 1845, Charcot was appointed provisional intern in 1847, during which time he earned the admiration and confidence of his mentor, Pierre Rayer (1793-1867). 2,10pon Rayer's recommendation, Charcot was appointed as an agrégé (associate professor) at the École de Médecine and introduced to the Societé de Biologie in 1851, which provided him with valuable access to the scientific community. 8etween 1853 and 1855, Charcot served as a chef de clinique at the Hôpital de la Charité under the leadership of his master Pierre Adolphe Piorry (1794-1879). 8In May 1856, he was appointed to the Bureau Central of Paris (médicin des hôpitaux). 10In 1857, due to difficulties in expressing himself orally and presenting a controversial thesis on "De l'expectation en médicine," which was deemed insufficient, he failed in his attempt to become an agrégé.Nevertheless, he succeeded in his second attempt in 1860 and assumed the position of agrégé intern of medicine and legal medicine, later being promoted to agrégé in exercise. 8In 1862, Charcot became the chef de service de La Salpêtrière, and in 1872, he won a public competition for the Chaire d'Anatomie Pathologique. 2,3,6,7In 1882, he became a clinical professor at the École de Médecine of the University of Paris and assumed the position of Chaire de Clinique des Maladies du Système Nerveux, a role he excelled in until his passing on August 16, 1893. 2,3,6,7uring his tenure, the neurological school at La Salpêtrière gained global recognition as the "Mecca of Neurology."A noteworthy fact that indirectly underscores Charcot's importance in the Parisian scientific community is his participation as a member of the thesis jury of the École de Médecine in Paris. 16In the period between 1862 and 1893, a total of 12,500 theses were submitted to the École de Médecine, out of which 3,663 were in the field of neuropsychiatry. 17Charcot, along with Alfred Vulpian (1826-1887) and Alexandre Axenfeld (1825-1876), were involved in 1,774 of these theses, with Charcot personally participating in 603 of them. 168][19][20] Despite not being known for his eloquence, Charcot's lectures were characterized by exceptional clarity and the visual impact of his illustrations.He skillfully engaged his audience, occasionally adding dramatic flair when presenting various classic neurological syndromes.[5][6][7]21

CONTRIBUTIONS TO NEUROLOGY AND NEUROPATHOLOGY
3][24][25][26][27][28] Furthermore, it should be remembered that the coronal section of the brain ("coupe verticale et transversale du cerveau") is known as the "Charcot cut." 23,29,30 In 1868, Charcot provided the classic description of "sclérose en plaques disséminées" (multiple sclerosis), employing the famous anatomo-clinical method, which involves a rigorous semiological evaluation of patients followed by neuropathological studies.][36] In 1886, Charcot and his disciple Pierre Marie made the initial description of the hereditary sensory-motor peripheral neuropathy now recognized as "Charcot-Marie-Tooth disease."They analyzed five patients and referred to the condition as "atrophie musculaire progressive" (progressive muscular atrophy). 27,28,37Remarkably, three months later, Howard Henry Tooth (1856-1925) presented his thesis for the medical degree in England, entitled "The peroneal type of progressive muscular atrophy," which clearly identified the pathology in the peripheral nerves. 27,28,38harcot played a pivotal role in defining key clinical features of the Parkinson's disease (PD), including bradykinesia and muscle rigidity, which were distinct from the muscle weakness suggested by James Parkinson (1755-1824), another polymath.0][41][42] It is essential to recall that Charcot and Vulpian coined the term "Maladie de Parkinson," known earlier as "Shaking Palsy," in 1862. 39,43In 1892, Charcot presented a lecture on vibration therapy, discussing his clinical experience with PD using a vibratory chair.The treatment improved sensory symptoms, sleep problems and walking ability, but had limited impact on the tremor associated with PD.Despite Charcot's efforts, the vibrating chair's use for PD was largely disregarded after his passing due to relatively few positive effects observed. 44,45Furthermore, Charcot's investigations in the study of movement disorders included distinguishing multiple sclerosis tremor from similar manifestations seen in mercury poisoning, and hysteria.7][48][49][50] Gaetano Rummo (1853-1917) translated and transcribed these lectures into Italian, which resulted in the book "Differenti forme d'aphasia," published in 1884. 51Charcot, known for his ability to make visual representations of complex concepts, received recognition as a "connectionist" or "diagram maker," including for the remarkable "bell diagram" describing the circuits of the speech process, first presented in Rummo's book (►Figure 3A). 51,52n collaboration with Charles Joseph Bouchard (1837-1915), Charcot made significant contributions to the understanding of strokes, particularly cerebral hemorrhages.Their study led to the discovery of "aneurysms that developed on intracerebral arterioles." 53During the autopsy, Bouchard identified ruptured and intact aneurysms, providing evidence for this pathology, which was later named "Charcot-Bouchard's aneurysms." 53,54n addition to his extensive research on various aspects of neurology, Charcot made valuable contributions to the localization of cerebral and spinal cord diseases. 55He conducted studies on ophthalmoplegic migraine and epilepsies.Charcot's work on ambulatory fugue-poriomania resulted in a classic description of this condition.Charcot-Wilbrand syndrome, identified by a loss of dreaming and visual agnosia, was also a subject of his research.Additionally, he studied Souques-Charcot syndrome, a variant of Hutchinson-Gilford progeria.Charcot also provided a thorough account of Charcot-Joffroy syndrome, a rare form of cervical myelopathy.5][56][57][58] One of the prominent myelopathies during the 19th century was tabes dorsalis. 3,33In 1862, during their early collaboration at La Salpêtrière, Charcot and Vulpian made a significant breakthrough by establishing a crucial link between specific clinical symptoms and the underlying lesions associated with tabes dorsalis ("ataxie locomotrice").They observed degeneration or sclerosis of the posterior columns of the spinal cord and atrophy of the posterior spinal roots in affected individuals. 3,59Around the same time, Lewis A. Sayre (1820-1900) designed a device for suspending patients for scoliosis treatment.Osip Osipovich Motschutkovsky (1845-1903) applied Sayre's method to a scoliosis patient and noticed improvements in tabes dorsalis. 60Inspired by Motschutkovsky's findings, Charcot assigned Gilles de la Tourette to conduct therapeutic experiments on ataxic patients using suspension therapy.Charcot observed positive results in 14 out of 18 cases, with improvements in walking, balance, pain, and other aspects. 60,61However, the therapy did not demonstrate objective improvement and had associated risks and fatalities.Despite the uncertainties surrounding its mechanism of action, the treatment remained in use for over a decade due to Charcot's influence before eventually losing popularity. 62ndeed, Charcot initially believed neurological diseases were hereditary.However, the emergence of the germ theory, championed by Louis Pasteur (1822-1895), in the late 19th century, brought a paradigm shift to French medicine, suggesting microorganisms as disease agents.Charcot was skeptical but not entirely opposed to the new theory, staunchly defending "hereditarianism" for years. 62In 1882, Jean Alfred Fournier's (1832-1914) association of tabes dorsalis with syphilis marked a turning point, supporting an infectious etiology, contributing to the growing acceptance of the germ theory, including those within Charcot's circle at La Salpêtrière, such as Bouchard and Pierre Marie. 62,63As a result, Charcot's adher-ence to hereditarianism and resistance to the new theory led to a certain decline in his political power and influence within French academic circles. 62,64

CONTRIBUTIONS TO NEUROPSYCHOLOGY AND PSYCHIATRY
Charcot's significant contributions to the study of "hysteria" are evident in his research on this clinical condition, now  and disagreed with the traditional "uterine" explanation.1][72][73] Nonetheless, neither Charcot nor his disciples formulated any hypotheses explaining the underlying mechanism by which abdominal compression influenced their patients. 70][68][69] Influenced by Charles Richet's (1850-1935, future Nobel Prize winner in 1913) research on "provoked somnambulism," Charcot began using hypnosis as a therapeutic tool for hysterics in 1878. 74,75However, his convictions were not always well accepted by another important research group in this area, the École de Nancy, led by Hippolyte Bernheim (1837-1919).Debates surrounding hypnotism between Charcot's school and the École de Nancy garnered significant public attention, and a well-known crime added to the sensationalistic nature of the discourse.Charcot maintained a viewpoint opposing Bernheim's, asserting that only patients with hysteria could be successfully hypnotized. 74,76egrettably, Charcot's approach to discussing hypnosis was combined with pseudoscientific subjects such as clairvoyance and spiritism during his lectures, which drew disapproval from the academic community. 77,78His research on hysteria and hypnosis at La Salpêtrière influenced Gilles de la Tourette and others, while some of his close disciples, including Féré, Pierre Janet (1859-1947), Alfred Binet (1857-1911), and later Babiński, distanced themselves from the Nancy-Paris controversy. 76,78,79ARCOT SEMIOLOGIST Throughout his career, Charcot presented his cases with rich detail on semiology.He not only described new signs, but also reinterpreted previously described findings. 2,3,6,7Charcot described what is known as the biliary triad or "Charcot's triad." 80he triad is characterized by the presence of recurring abdominal pain in the upper right quadrant associated with fluctuating jaundice and intermittent fever with shivers, and it is associated with the presence of acute cholangitis caused by choledocholithiasis. 80 In patients with sclérose en plaques, the presence of nystagmus, intentional tremor, and dysarthria (staccato speech) has also become known as "Charcot's triad."The "Charcot's sign" occurs when there is eyebrow elevation in peripheral facial paralysis. 8In 1890, Charcot described areas of the body whose compression causes hysteria, the "Charcot's zones."These areas overlapping fibromyalgia tender points (►Table 2). 81 Charcot's innovation for semiology was the systematic taking of residents' temperatures with a mercury thermometer, rather than simply by hand.His intern for 1868, Bourneville, would make this the subject of his thesis and other subsequent publications. 8The ocular fundus examination, with an ophthalmoscope, was a new technique invented by Hermann von Helmholtz (1821-1894), in 1851.The importance of fundoscopic examination to the clinical practice of neurology was appreciated by Charcot, who was an early adopter of the ophthalmoscope, and found it useful in some trying differential diagnosis, as in the lecture "De l'amaurose tabétique", where he wrote "However, ophthalmoscopy, in this situation, came to bring us a decisive contribution." 82,83

CONTRIBUTIONS TO INTERNAL MEDICINE
Charcot described many diseases in different areas of internal medicine, causing him to be defined as the "discoverer of diseases" (►Table 3). 158,84 His talents as a draftsman are revealed in the plate of hands with deformed fingers illustrating his thesis (►Figure 4). 8Throughout his career, Charcot remained knowledgeable about rheumatic diseases and gout, and in 1863, he reported Alfred Baring Garrod's (1814-1917) observation of the high frequency of gout in those with previous signs of lead intoxication. 8,85][87][88] In 1835, Robert James Graves (1796-1853) described cases of tachycardia and thyroid enlargement in young women, attributing them to a cardiac lesion and creating the cardiovascular theory with William Stokes (1804-1878). 89In 1840, Carl A. von Basedow (1799-1854) associated palpitation of the heart, exophthalmos, and goitre, known as the Merseburg Triad, and suggested a cause related to a "dyscrasia of the blood." 90In 1856, Charcot presented a case series of this disease, rejecting the cardiac cause and focusing on structural changes in the thyroid arteries.He proposed increased gland activity due to vasomotor nerve stimulation.In 1859, he reported a case with a fatal meningeal hemorrhage completing the disease's evolution.Charcot also described different tremors in the disease, leading to the term "Charcot-Marie's signal." 8Armand Trousseau (1801-1867) admired Graves and Stokes, using the term "Graves' disease" in his clinical lectures. 8hen Graves' textbook was translated into French, Trousseau wrote the foreword in which he commended to readers the work of Graves and indeed first used the term "Graves' disease." 89In contrast, Charcot followed the Germanic school and endorsed August Hirsch's (1817-1894) proposal to name

Pulmonary embolism Ball -1858
In a pulmonary embolism case, Charcot described the pathophysiology showed that the clot obstructing the artery was from venous phlebitis of a lower limb.He recognized the elevation of fibrin as a factor promoting clot formation.

Intermittent arterial claudication 1859
Charcot elucidate the pathophysiological mechanism of ischemia.
Charcot-Weiss-Baker syndrome 1872 He described a type of syncope triggered by coughing as well as syncope triggered by compression of the carotid sinus.

Gangrenous dissecting pneumonia
Ball -1860 They envisioned septic emboli before the era of microbiology.
the condition "Basedow's disease."This eponym is still used in non-Anglophone countries to this day. 8ith Vulpian, Charcot presented an observation of Addison's disease to the Société de Biologie in 1857.Macroscopically, the adrenal glands appeared normal, but microscopic observation showed degeneration: "after the ordinary symptoms of Addison's disease, the adrenal capsules would be given as healthy, without having been examined under the microscope or treated with suitable reagents.From the point of view of theory, this should be regarded as untrue." 8he use of the microscope, for which Charcot always had great enthusiasm, also contributed to his important discoveries.In 1857, he published an article on "melanemia" where he identified colored corpuscles derived from the regressive metamorphosis of red blood cells in certain pathological conditions.He attributed melanemia to the spleen and liver's activity and associated it with nephritis in malarial fever cases.However, Charcot rejected melanemia as the cause of neuropsychic disorders during malaria and wondered whether it should be considered a symptom or a disease, mainly focusing on its relation to fevers. 8n 1853, Charcot and Charles Philippe Robin (1821-1885) presented a case of acute leukemia to the Société de Biologie.During the autopsy, Robin noted that in the blood of the right ventricle, there was a large quantity of blood crystals, which were very regular in shape and slightly colored yellowishred.These crystals were also found abundantly in the spleen tissue, forming considerable clusters visible only under the microscope.In 1860, Charcot and Vulpian, referring to another leukemia case, described these crystals as "very elongated octahedrons, very regular in shape and fairly uniform," measuring 6 to 8 μm (►Figure 3B). 91These crystals later became known as Charcot-Leyden crystals in honor of Charcot and Robin's 1853 description, with the addition of the name of Ernst Victor von Leyden (1832-1910), who identified them in the sputum of asthmatics in 1872. 92Similarly, Charcot-Neumann crystals, which contain phosphate crystals, were described in semen. 4ntermittent claudication of arterial origin ("claudication intermitente par oblitération artérielle"), originally described by Charcot ("Charcot's intermittent claudication"), is characterized by the presence of pain, discomfort, weakness, or leg cramps, mainly after physical exercise or walks and disappear after rest. 84,93,944][95][96] He based his study on the description, published in an article in 1831 by the Parisian veterinary surgeon, Jean-François Bouley, of claudication in a horse that pulled a carriage through the streets of Paris and had difficulty using its hind feet whenever it had to exercise more strenuously.The animal presented thrombi obstructing the femoral arteries. 95rançois-Amilcar Aran (1817-1861) wrote his dissertation in 1853 on the causes of sudden death, including pulmonary embolism, but without specifying its pathophysiology.Benjamin Ball (1833-1893) and Charcot showed in 1858 that the origin of the clot obstructing the pulmonary artery was venous phlebitis of a lower limb.Charcot recognized the elevation of fibrin as a factor favoring clot formation, even though the physiology of hemostasis was still in limbo.He noted the higher frequency of these diseases in young people, especially with a traumatic injury. 8nother contribution related to the field is Charcot's edema, a painful and bluish edema described in women with hysterical paralysis. 84,93Charcot gave a detailed description of vasovagal syncope, which is characterized by transitory attacks of significantly reduced heartbeat, reduced arterial pressure, and loss of consciousness. 84Then, in 1872, he helped clarify a syncope triggered by coughing, by compression of the carotid sinus (carotid sinus hypersensitivity syndrome), described by Johann Nepomuk Czermak (1828-1873) in 1866.Its pathophysiology was comprehensively described by Soma Weiss (1898-1942) and James Porter Baker (1902-1988). 97This syndrome is also known as the Charcot-Weiss-Baker syndrome. 84,88Furthermore, Charcot conducted investigations on sore pressure. 98harcot made significant contributions to various areas of internal medicine, including nephrology and infectology (►Table 3).In his early lessons, he discussed fever, conditions like la gravelle biliaire, pneumonia, and more, without the knowledge of microbiology, which had not yet been established.Charcot and Ball presented a case in 1860 of a woman with heart failure and mitral stenosis who underwent puncture for ascites.Unfortunately, the procedure led to complications, including erysipelas and gangrenous necrotic tissue, resulting in her death.They used the term "gangrenous dissecting pneumonia," introduced by the German Hermann Lebret (1813-1878) in 1845, envisioning septic emboli before the era of microbiology, suggesting the spread of septic liquids from a primitive focus or blood clots carrying gangrenous fluid. 8e can also be considered to have pioneered the study of diseases of the elderly, although his contributions in the fields of geriatrics and gerontology are scarce, focusing mainly on gout and chronic rheumatism. 31,99,100He was also one of the pioneers in establishing rehabilitation clinics with physiotherapy, speech therapy, hydrotherapy, and electrical stimulation of paralyzed muscles. 3

CHARCOT: AN INTELLECTUAL
In his book published in 1988, Paul Johnson, defines intellectuals, presents a series of them, and highlights their moral qualifications, capacity for discernment, and characteristics that qualify them to guide humanity. 101Charcot had all the basic characteristics for be defined as an intellectual.6][7][102][103][104][105] He was a man of strong personality and his features emanated a respectable figure.][107][108][109][110] Charcot's characteristics regarding the arts, in particular painting and sculpture, were quite eclectic. 2,3,6,7He had great admiration for the sculpture of ancient Greece, Italian paintings of the Renaissance period, as well as Belgian and Dutch paintings. 2One of his favorite painters was Delacroix. 2lthough Charcot lacked the ability to play musical instruments, he had an exceptional taste for music.His favorite classical composers were Mozart, Beethoven, Rameau, Gluck, as well as César Franck and Hector Beriloz. 2,3,6,7In the area of literature, he knew all of Shakespeare's works, of which he was a great admirer and claimed him as his favorite writer.Charcot had a great interest in the area of philosophy, and liked the classic Greek and Latin books, particularly by Plato and Seneca. 2,3,6,7ven though he was not politically engaged, Charcot had liberal ideas, and even though he was tolerant in religious matters, he was clearly anti-clerical. 3,106,111Nevertheless, his wake in the chapel of the La Salpêtrière and burial in the Montmartre cemetery were performed within Catholic norms. 2,3,6,7,111,112Some biography data suggest that Charcot, in the final phase of his life, came to admire Buddhism. 1133][104][105] Notably, one of his disciples, Henry Meige (1866-1940), published a book in 1925 titled "Charcot Artist," wherein he showcased a collection of original drawings by Charcot.These drawings encompassed environments, landscapes, family members, colleagues, church sculptures, and several caricatures, some of which exhibited a sense of self-ridicule. 104The book "Charcot -Une vie avec l'image," published by Catherine Bouchara in 2013, provided substantial insight and a comprehensive perspective.It also presented numerous drawings by Charcot, showcasing his astute observation of patients' postures and neurological signs, always correlated using the renowned anatomo-clinical method.The book featured various drawings of patients with hysteria, family members, in particular his son, Jean-Baptiste and daughter, Jeanna, landscapes from his international travels, and several caricatures. 105harcot's own book titled "Huit jours au Maroc" ("Charcot in Morocco") chronicled his trip to Morocco in 1887 and contained numerous drawings, featuring landscapes and local characters, notably from the Jewish community.102,114 Furthermore, Charcot authored an article later compiled into a book titled "La foi qui guérit" ("Faith Healing").115 Contrary to his prior skepticism regarding neurological disease treatments, Charcot objectively explored the significance of faith as an auxiliary element in treating patients with neurological ailments.He included conversion pictures related to hysteria, which foreshadowed the later development of psychosomatic medicine.115 Charcot collaborated with his assistant Paul Richer on the book "Les Démoniaques dans l'Art," published in Paris in 1887.103 This work, illustrated by Richier, depicted hysterical symptoms in religious and religious art, including Charcot's descriptions of hysteria in religious contexts and his "hysterical saints."It also explored Charcot's contributions to the field of functional disorders and their implications.103,116 Another joint publication by Charcot and Paul Richer in 1889 was "Les Difformes et le Malades dans l'Art" ("The deformed and diseases in art"), further discussing the intersection of science and art.117 Moreover, Charcot actively encouraged his disciples, such as Bourneville and Paul-Marie-Léon Regnard (1850-1927), to share the neurological findings of their group at La Salpêtrière through various journals.The "Iconographie Photographique de la Salpêtrière," created in 1876, particularly emphasized hysteria, and later, the "Nouvelle Iconographie de la Salpêtrière" covered a wider range of neurological diseases.3

Charcot caricaturist
Charcot's relationship with various aspects of art in general, which at first started as a hobby and later became more scientific, also turned toward caricature. 102,104,105In this area, his works demonstrate significant artistic skills, which are clearly evident in Henry Meige's book entitled "Charcot Artiste" and the more recent text by Catherine Bouchara entitled "Charcot -Une vie avec l'image". 104,105In 2021, Teive et al. 102 published a historical note to discuss the artistic side of Charcot through his caricatures.This historical note briefly describes eight caricatures during the second half of the nineteenth century in Paris, demonstrating his artistic gifts blended with humor, satire, irony and sarcasm. 102►Figure 5 fully demonstrate these characteristics.

CHARCOT: THE LOVER AND PROTECTOR OF ANIMALS
Charcot was known for his strong sensitivity toward animals and was against hunting and bullfighting due to the unnec-essary cruelty inflicted on animals.Charcot's compassionate nature extended to love for animals, and he treated them with tenderness and care. 6,7,108,109Guinon 6 reported the scene of Charcot being seen threateningly running behind a duck to catch a frog trapped in its beak.
In his personal life, Charcot had two dogs and a small female monkey named Rosalie, given to him as a gift by Pedro II, the Emperor of Brazil.He developed a close bond with Rosalie, and she would join him at the table during his meals.Charcot would ensure she had enough food and delighted in her playful antics, finding joy when she grabbed nuts or bananas from his plate.The presence of animals, particularly dogs, was a constant in Charcot's home at 217 Boulevard Saint-Germain in Paris. 2,6,7,109,110harcot's approach to scientific research was distinct from his contemporaries.He firmly opposed vivisection and experiments involving animals at La Salpêtrière, where most of his neuroanatomical and neuropathological studies were based on human autopsies. 3,6,7,109,110His stance against animal experimentation was evident in his office, where a sign painted by his wife clearly stated, "You will find no dog laboratory here." 3,6,7,108,109This sign symbolized his strong conviction against the use of animals for experimental purposes.Despite his dedication to human autopsies and his contributions to the field of neurology, Charcot's opposition to vivisection received criticism from some members of the scientific community, especially those associated with the École de Médecine.

DEATH
Two months following his tiring and counterintuitive journey to England, his wife asked him to rest, as his angina attacks were becoming more frequent.Charcot embarked on a cultural expedition with two of his pupils Isidore Straus (1845-1896) and Maurice Debove (1845-1920) to Vezelay and its basilica, in Burgundy.Tragically, on August 16th, 1893, at three o'clock in the morning, he experienced a severe pulmonary edema as a consequence of cardiac insufficiency secondary to myocardial necrosis.He away in a modest guesthouse located by the lake des Settons.Among his co-morbidities were obesity, heavy smoking, and lombalgia. 2,3With his demise, the world lost the esteemed "César de la Faculté," the renowned "Napoleon des névroses," and the venerable "father of Neurology." 3,62,118n conclusion, the celebration of the 200th anniversary of the birth of Jean-Martin Charcot is approaching, and it is scheduled to take place with great dignity in Paris in 2025 during the annual meeting of the International Society for the History of the Neurosciences (www.charcot2025.fr).It is important to remember his numerous contributions to internal medicine, neurology, neuropathology, neuropsychology and neuropsychiatry.These accomplishments, in addition to his recognized and expressive artistic production and socio-cultural influence, certainly deserve him the acknowledgment as a polymath.

Figure 3
Figure 3 Charcot's drawings for scientific publications.(A).Charcot's Bell -Aphasias (Charcot and Rummo, 1884): The bell (campana [cloche]) rings, it is heard and seen.The centers were defined by clinicopathological analysis.Inputauditory input: CAC: center of shared hearing, and CAM: auditory center for words; visual input: CVC: center of shared vision, and CVM: visual center for words.Outputspoken output: CPM: center of articulated language; written output: CGM: center of written language.IC: ideation center.Arrows show the direction of the nervous paths connecting the centers.(B).Charcot-Leyden's Crystals (Vulpian and Charcot, 1860).

Figure 4
Figure 4 Charcot's thesis, defended at the Faculty of Medicine at the University of Paris in 1853.Charcot drew the joint deformities to illustrate his doctoral thesis.(Charcot, 1853).

Figure 5
Figure 5 Caricatures by Charcot.Clockwise from top: (1) Professor Michel Eugene Chevreul (1786-1889) during Charcot's visit to a Tuesday session at the Academy of Sciences in Paris around 1885; (2) "The Areopagus," Charcot drew his medical school colleagues as apes; (3) An old companion from his youth nicknamed "Platypus," on an excursion in the mountains of Switzerland; (4) Faculty procession: his colleagues at the Paris medical school in pompous costumes during a procession; (5) The final two images portray his indignation during the Franco-Prussian war (1870): the first is untitled, depicting a tiny French soldier atop an enormous, inert Prussian one, and the second he called "L'Avenir" ("The Future").Source: Walusinski, personal collection.

Table 1
Charcot's contributions to neurology, neuropathology, and psychiatry 1888Charcot described a 37-year-old mailman with fugue-poriomania, experiencing three hourlong episodes of wandering around Paris with complete amnesia.This case is now understood as non-convulsive status epilepticus

Table 3
Charcot's contributions to internal medicine